New Weight-Loss Injections and Pills: Retatrutide, Orforglipron, the Wegovy Tablet and Where They Stand

As of: October 2026

Of the new weight-loss medicines, two are approved in the EU so far, both prescription-only, only prescribed by a doctor and both under the name Wegovy. One is the Wegovy tablet, approved since July 2026 and in German pharmacies since September 1, 2026. The other is the higher weekly dose Wegovy 7.2 mg, approved since early 2026. Orforglipron, retatrutide, CagriSema and survodutide, on the other hand, are not approved in the EU. The European Medicines Agency (EMA) is currently reviewing orforglipron. And for retatrutide there is no application for approval anywhere in the world so far, even though it is already being offered online.

In recent weeks several new names have made the news at once, and not every one of them has actually reached a pharmacy yet. That's why, for every medicine here, the first thing you'll read is whether it is approved in the EU. After that come the most important study with its result, length and placebo value, and who paid for it. This is not a recommendation, it's a dated snapshot, so that you can place the new names correctly.

What new weight-loss injections and weight-loss pills are there?

For the four unapproved active ingredients, results from phase 3 are available. That is the large study stage on which an application for approval is based. There, the comparison is with a placebo, a dummy medicine with no active ingredient.

We put this table together ourselves from the studies and the EMA documents. All numbers are averages for adults without diabetes, mostly with additional nutrition and exercise counseling. Individual results vary widely. The six were not compared with each other in any study, and for the four unapproved ones, safety over many years is still an open question. Stronger in a study therefore doesn't mean better for you. How the established injections differ is covered in our comparison of the approved injections.

Is there a weight-loss injection in pill form?

Yes, as the Wegovy tablet, semaglutide has been approved in the EU for weight management since July 14, 2026, prescription-only just like the injection. The EMA calls it the first oral GLP-1 treatment for weight management. GLP-1 is a gut hormone your body releases after eating, and one of the things it does is make you feel full. Semaglutide mimics it.

The prescription-only tablet is approved for adults with a body mass index of 30 or more, or 27 or more if there is at least one weight-related health condition. It, too, is always intended as an adjunct to a reduced-calorie diet and increased physical activity. The trial behind it is called OASIS 4 and was funded by the manufacturer Novo Nordisk. In it, 307 adults without diabetes took 25 mg or a placebo every day for 64 weeks, and with semaglutide they lost an average of 13.6% of their weight, compared with 2.2% on placebo. Gastrointestinal complaints affected 74.0% compared with 42.2% on placebo, more on that under side effects of GLP-1 injections.

Taking it is more involved than you might think for a tablet, though. According to the summary of product characteristics (SmPC), the product information for professionals approved by the EMA, it is taken after at least 8 hours without food with no more than 120 ml of water. After that you wait at least 30 minutes before eating, drinking or taking other tablets. Treatment starts at 1.5 mg, then goes up in steps of at least four weeks via 4 and 9 to 25 mg. How fast is decided by your doctor.

Semaglutide as a tablet isn't completely new. Since April 2020 the active ingredient has been available as Rybelsus, prescription-only and approved exclusively for the treatment of type 2 diabetes, even up to 50 mg. So what's new about the Wegovy tablet isn't the dose, it's its own approval for weight management.

What's new about Wegovy 7.2 mg?

Wegovy 7.2 mg is a higher weekly dose of the same injection, approved in the EU since early 2026 and prescription-only. It is intended only for adults who had a BMI of at least 30 at the start of treatment. According to the SmPC, your doctor can increase to 7.2 mg after four weeks on 2.4 mg at the earliest. If weight doesn't keep dropping with it, it goes back to 2.4 mg. According to the trade press, the dose has been available as a separate pen in Germany since mid-September 2026.

The STEP UP trial included 1,407 adults with obesity without diabetes, also funded by Novo Nordisk and medically supervised. There, weight dropped over 72 weeks by an average of 18.7% with 7.2 mg, by 15.6% with 2.4 mg and by 3.9% with placebo. That is around 3 percentage points more than with the previous dose, though with more side effects. Gastrointestinal complaints affected 70.8% compared with 61.2% on 2.4 mg, unusual skin sensations 22.9% compared with 6.0%.

What is orforglipron?

Orforglipron is an active ingredient in tablet form that is not approved in the EU, as of October 2026. In September 2026, the responsible EMA committee still had open questions about the application on its agenda. The small, synthetically made molecule docks onto the same site in the body as semaglutide, the GLP-1 receptor. Outside the EU, orforglipron has been approved in the US since April 2026 and in the UK since August 10, 2026.

The phase 3 trial ATTAIN-1 was funded by the manufacturer Eli Lilly. In it, 3,127 adults with obesity without diabetes took 6, 12 or 36 mg or a placebo every day for 72 weeks under medical supervision. They lost an average of 7.5, 8.4 and 11.2% of their weight, compared with 2.1% on placebo. Because of side effects, 5.3 to 10.3% stopped taking it, compared with 2.7% on placebo. How safe this active ingredient, which is not approved in the EU, is over many years is still an open question.

What is retatrutide?

Retatrutide is injected weekly, is not approved in the EU and, as of October 2026, had not been submitted for approval anywhere either. It acts on three receptors at the same time: the one for GLP-1, the one for GIP, a second gut hormone, and the one for glucagon. The first large phase 3 trial is called TRIUMPH-1, funded by the manufacturer Eli Lilly and published on September 29, 2026. In it, 2,339 adults with obesity without diabetes received 4, 9 or 12 mg or a placebo for 80 weeks under medical supervision. As a result they lost an average of 17.6, 23.7 and 25.0% of their weight depending on the dose, compared with 3.9% on placebo.

On tolerability, there are numbers from the parallel trial TRIUMPH-2 with 1,152 adults with type 2 diabetes, also funded by the manufacturer. There, 12% on 9 mg and 8% on 12 mg stopped treatment because of side effects, compared with 5% on placebo. How safe the unapproved retatrutide is over years, nobody knows today. Lilly says it plans to file an application in the US in the first quarter of 2027, and the manufacturer gives no date for the EU.

Where do CagriSema and survodutide stand?

CagriSema and survodutide are not approved in the EU, as of October 2026. No submission to the EMA is known for either of them, and data over many years are still missing. CagriSema is a weekly injection that combines semaglutide with cagrilintide, a second satiety hormone. In the medically supervised phase 3 trial REDEFINE 1, funded by the manufacturer Novo Nordisk, weight in 3,417 adults without diabetes dropped by an average of 20.4% after 68 weeks, compared with 3.0% on placebo. In the US, CagriSema has been submitted since December 2025, according to the manufacturer.

Survodutide, which is also not approved, is injected weekly as well and acts on the receptors for GLP-1 and glucagon. In the phase 3 trial SYNCHRONIZE-1, funded by the manufacturer Boehringer Ingelheim, 725 adults without diabetes under medical supervision lost an average of 12.2 and 13.0% of their weight after 76 weeks, compared with 5.4% on placebo. In both trials, clearly more people had gastrointestinal complaints than with placebo. With CagriSema it was 79.6% compared with 39.9%, with survodutide up to 89.7% compared with 47.9%.

What about retatrutide offers on the internet?

Anyone who is offered retatrutide anywhere today isn't getting an approved medicine, they're getting a substance of unverified quality without medical oversight. Even so, there are websites offering retatrutide and other unapproved active ingredients to order as "peptides". The German consumer advice centre (Verbraucherzentrale) is very clear even about the approved weight-loss injections: offers without a prescription requirement are illegal in Germany. For an active ingredient that isn't approved anywhere, there is all the more no legal route outside a clinical trial.

How real the risk is can be seen from the counterfeits of the approved medicines. According to the EMA, authorities found falsified Ozempic in the supply chain in October 2023, a semaglutide product approved exclusively for the treatment of type 2 diabetes. The Drug Commission of the German Medical Association (AkdÄ) warned at the time that counterfeits of the diabetes medicine Ozempic (semaglutide) are in circulation and probably pose health risks. The safe route goes through your doctor's office and a licensed pharmacy. And that route so far only exists for approved medicines.

What does this mean for you, whichever medicine it is?

Which medicine suits you, injection or tablet, is a medical decision. The German S3 guideline on obesity states that medicines are always part of a basic therapy of nutrition, exercise and behavior. According to the guideline, what counts for the choice includes tolerability, existing conditions, the way it is used and how well a medicine works for you. None of that is in a study table.

What all these medicines have in common is that they act on the GLP-1 receptor and thereby on appetite. So you eat less. The smaller the portions get, the more depends on what's on them, and a tablet or a third receptor doesn't change that. The good news: for protein and training there are now European numbers that aren't tied to any particular medicine. The European expert consensus on nutrition and training with these treatments recommends 1.0 to 1.5 g of protein per kilo of adjusted body weight a day while you are losing weight, and at least 60 g. Adjusted means that only part of the kilos above a normal weight goes into the calculation. For training, it relies on strength exercises on at least two days a week, as a goal for the longer run. We help you with answers on what belongs on your plate now, how much protein you need per meal, how to keep your muscles while losing weight and which nutrients can fall short with small portions. The big picture is in our main article on the weight-loss injection.

FAQ

When will retatrutide be available in Germany?

There is no date yet. Retatrutide is not approved in the EU and hasn't been submitted for approval anywhere so far, as of October 2026, and the manufacturer gives no date for the EU. In Germany it can only be prescribed by a doctor after EU approval. How long that review takes can't be said reliably in advance.

Is the Wegovy tablet as effective as the injection?

In the pivotal trials, the tablet and the injection performed similarly. The EMA writes in the SmPC that efficacy and safety in OASIS 4 and STEP 1 were comparable regardless of the route of administration. The difference lies more in everyday life, daily on an empty stomach with a waiting time or once a week. Which of the two prescription-only forms suits you is something you clarify with your doctor.

How much does the Wegovy tablet cost?

For self-payers, the prescription-only Wegovy tablets in the low strengths start, according to the German pharmacy magazine Apotheken Umschau, at around €172 for 30 tablets, so 30 days, and the 9 mg strength costs around €233 according to the Pharmazeutische Zeitung, as of October 2026. Statutory health insurance (GKV) doesn't pay for them, because under Section 34 of the German Social Code Book V (SGB V), medicines for regulating body weight are not covered. More on this under what Wegovy and Mounjaro cost self-payers.

Is Mounjaro or tirzepatide available as a pill?

In the EU, tirzepatide (Mounjaro) is prescription-only and approved for injection only, as a pre-filled pen, KwikPen or vial. That is what the Mounjaro SmPC says. The Eli Lilly tablet people often ask about in this context is a different active ingredient, orforglipron. This active ingredient is not approved in the EU, as of October 2026.

Which new weight-loss medicine works best?

As of October 2026, the highest average values in a study were seen with retatrutide, which is not approved in the EU, in TRIUMPH-1, but little is known yet about its long-term safety. None of the new medicines was tested against another. And strongest in a study doesn't mean best for you. What counts for that is tolerability, safety and your existing conditions, and that is something you clarify with your doctor.

Do I have to change my diet with a new medicine?

Little changes in principle, and that actually makes it easier for you. All these medicines act on appetite. What counts then is that there is enough protein, vegetables and whole grains on the smaller plate. Whatever habits you build for that, you take with you into any treatment.

Disclaimer:

This article is for informational purposes only and does not replace medical advice, diagnosis, or treatment by a physician or pharmacist. The information provided here should not be used for self-diagnosis or self-treatment. Food supplements are no substitute for a balanced, varied diet and a healthy lifestyle. For any health questions or complaints, please always consult a doctor you trust. Fifty Five accepts no liability for any inconvenience or harm resulting from the use of the information presented here.

And since this is about prescription medicines, one more word from us: Fifty Five does not sell medicines, and any questions about your treatment, your dose or stopping it are best taken to your doctor.

Sources

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